Is it possible to predict, prevent pitchers' injuries?
Major League Baseball teams spent $1.7 billion from 2002-12 on pitchers on the disabled list, according to a presentation at the Milwaukee Brewers' medical symposium this offseason.
Of 360 pitchers who began this season on major league rosters, 124 — more than one-third — have had Tommy John surgery, according to Sports Illustrated injury expert Will Carroll.
Injury rates continue to rise as the failure to keep pitchers healthy remains the game's greatest market inefficiency.
But a growing number of people in the industry think pitching injuries can be reduced through predictive and preventative practices, thanks to advances in technology and an influx of open minds.
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In spring 1989, Rick Peterson was in spring training with the Chicago White Sox, preparing to break camp as the pitching coach with Double-A Birmingham. The front office asked him to visit the then-new American Sports Medicine Institute laboratory of Dr. James Andrews when he arrived in Alabama.
The lab opened two years earlier to study sports-related injuries. Andrews, who recently had performed shoulder surgery on Roger Clemens, decided to first study pitching injuries.
Peterson knew injury well.
After graduating from Mt. Lebanon High School, Peterson attended Gulf Coast (Fla.) Junior College where, in 1974, he injured his right shoulder. Peterson was drafted in the seventh round by the Pirates that spring. His father, Harding “Pete” Peterson, was the Pirates' farm director and future general manager. But Rick Peterson's arm was never the same. He posted a 6-11 record and 5.68 ERA in an eight-year minor league career.
Fifteen years after feeling his shoulder pop, Peterson walked into the ASMI lab.
“It was an enlightening experience. It was the beginning,” Peterson said. “I was the first person who got an analysis. (ASMI research director Dr. Glenn) Fleisig and I analyzed the high-speed film together. The next time I came, we started bringing our own pitchers in there and getting analysis. We also went back and looked at videotape and looked at film of Bob Gibson and Tom Seaver and Nolan Ryan, some of the best pitchers in the game but also pitchers that had longevity. We were curious if there was some common thread.”
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It was the beginning of biomechanics, a scientific approach to injury prevention.
At the ASMI lab, sensors are attached to various points on a pitcher's body that allow computers to map his movement, three-dimensionally, and measure force on critical areas of the body. They are compared to measurements from a database of 100 pitchers that are designated as elite because of their performance and durability. A biomechanical evaluation places red flags on certain mechanical traits.
Fleisig has studied more than 2,000 pitchers, including seven Cy Young Award winners.
“We found a consistent measurement among good pitchers and then thought about it medically and anatomically,” Fleisig said, “and why this made sense about the laws of physics.”
In 1998, the A's were searching for someone to put a new pitching program in place. They hired Peterson. Peterson said the A's were the first team to fully embrace biomechanics and take healthy pitchers to a biomechanics lab for preventative testing.
In 2002, A's starting pitchers Tim Hudson, Barry Zito, Mark Mulder and Cory Lidle made at least 30 starts apiece.
In 2003, the A's top four starters again combined to average 31 starts.
In 2004, the A's had only six pitchers make starts the entire season.
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For the past 20 years, astrophysicist Meredith Wills did what some said was impossible while researching for NASA: She developed a tracking system to monitor solar storms on the sun. Now she's interested in tracking something else considered impossible: predicting baseball injuries.
“I wanted to do something else, and I realize the skill set that I had developed in astrophysics was, in fact, applicable to baseball,” said a Wills, a self-described baseball fanatic.
By tracking and recording player movement on the field via sensors, Wills' system might prevent an injury by noting changes to a pitcher's arm motion or stride length.
“As far as I'm concerned, a decade down the line, people aren't going to remember not having it,” Wills said. “For instance, the K-Zone on the TV screen. Everyone thinks in terms of PitchFx data now even though it's a fairly recent addition.”
Another real-time technology teams are experimenting with is ultrasound, SI's Carroll said.
“You can see (elbow ligaments) before they break,” Carroll said. “There's technology out right now and you can go out and in between every inning and you visualize a guy's ligament. There's only three teams doing it that I know of.”
What also could help is predictive analytics.
The Leicester Tigers rugby club in England benefits from computers using variables such as sleep, stress and training levels to create fatigue thresholds and form predictive analytics, according to the BBC.
The Pirates' director of baseball systems development, Dan Fox, wrote in an email that predictive analysis is “an area that we look at and we do create predictive models.” But he added, “(It's) also an area where we as an industry have a long way to go.”
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Despite the advances in technology, Carroll said the industry largely has been resistant in taking injury prevention seriously.
Carroll said there are 12 teams that give their pitchers biomechanics evaluations, but 10 of those teams, including the Pirates, give only a limited number of pitchers evaluations.
Only two clubs, the Brewers and Orioles, are fully committed to biomechanics. Peterson is now the director of pitching development for the Orioles, which sent only two pitchers to the disabled list last season. Brewers players have had the second-lowest number of days lost to the disabled list over the last decade.
“(As an industry) we're doing things the same way we did 10 years ago,” Carroll said. “There are teams that are going to have a really massive five-year advantage because they got there first (in injury prevention).”
Carroll said it would cost a club roughly $100,000 to biomechanically evaluate its entire 40-man roster and top prospects each year, a minimal cost compared to a lengthy DL stint. Carroll has been told by some in baseball that a dollar not spent on payroll is a dollar wasted.
A handful of clubs have expressed interest in Wills' StarTrack system, but baseball is resistant because the system requires placing sensors on players in game action.
“It's just a question of getting baseball to sign on to the 21st century,” Wills said, “or even the 20th century.”
Pirates general manager Neal Huntington said clubs are careful about making significant changes to pitchers' motions.
“There are not many pitchers that have made wholesale changes to their arm action and stayed healthy,” Huntington said. “When you make wholesale changes in arm action, you've put at risk muscle groups and tendons that have been built up for 10, 15 years in one way.
Said Seattle GM Jack Zduriencik: “Muscle memory is a big thing.”
Players are often resistant to change routine.
“I think (a biomechanical evaluation) would be something that would be personal to me,” Giants pitcher Tim Lincecum said. “If they came to me with something like that, I don't know.”
Teammate Matt Cain has his doubts about whether science can provide answers.
“Everyone has natural motion, and it's not the same,” Cain said. “We are kind of in awe when we see these softball girls throw back-to-back days thinking, ‘How do you do that?' That couldn't happen here. We kind of joke about it: If you threw a 100 pitches every day, how long would you last? Not very long. Pitching overhand is so unnatural.”